OB 2 Ch 57

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OB 2 Ch 57
2012-07-31 20:58:38

Amniotic fluid, fetal membranes, and fetal hydrops
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  1. Amniotic fluid is comprised of
    -electrolytes (salt, water)
    -fetal waste products (urine)
    -fetal cells
        -vernix: skin cells, fatty substance
        -fetal hair: _______
    -Abnormalities can
      -interfere with normal fetal development
      -structural anomalies
      -hypoplastic lungs
      -can also be assoc w/ congenital anomalies
  2. Amnion usually visible TV by ___ weeks
  3. Fluid production
    -________ is 1st producer of fluid
    -placenta hasnt formed yet
    -later on, placenta produces fluid
    -umbilical cord
    -fetal skin (up to 24 weeks- keratinization occurs)
    -fetal lungs
    -from _____wks and on, fetal kidneys
        -major producer of amniotic fluid from 2nd trimester on
    • -amniotic membrane
    • -8 to 9
  4. Amount of fluid present represents a balance of production and ______
  5. Production: __________
  6. Removal: __________
  7. Fetal swallowing by __ to ___ weeks
    9-12 weeks
  8. Primitive urine formation by ___ weeks
  9. Must be able to visualize stomach, must be seen by ___ weeks
  10. Functions:
    -keep fetus off the wall
    -allows movement
    -temperature regulation (homeostasis)
    -allows to symmetric growth: baby can grow in all directions
    -acts as a reservoir for fetal metabolites
        -baby swallows fluid
        -it passes thru GI tract
        -goes into bloodstream and heads to _____
        -mother's body excretes waste
  11. Amniotic fluid volume tapers at 34 weeks. Lungs are mature by ____ weeks. Children born early (28 weeks), lungs not mature: give child steroid shot to speed up maturation process.
  12. With multiples, can do a ____ volume assessment or 2 pockets on each sac (4 total)
  13. With ____________, aka hydramnios, volume is greater than 2000 ml, pt measures larger than dates, can signify issues with CNS or GI tract. Caused by:
    -increased output
    -decreased removal
    Preterm labor occurs, chronic polyhydramnios (after 28 weeks- should be starting to decline), acute polyhydramnios (happens over a couple of days). Associated with
    -skeletal abnormalities
    -preterm labor
    -twin to twin transfusion
    -good visualization of fetus
  14. ___________ is caused by congenital anomalies, IUGR, post term preg, ruptured membranes (persists, poor prognosis), iatrogenic causes, renal issues is the most common cause.
    Can cause:
    -skeletal abnormalities (talipes)
    -IUGR (fetal hypoxemia- available blood gets shunted to brain, bypassing kidneys)
    -can cause fetal demise
    -poor acoustic window for visualization
    -always assess kidneys when oligo is present, unless the cause is PROM
  15. With ________ - amniotic membrane is very sticky on the chorionic side. A segment of amnion can be torn away from chorion. It will attach to anything it comes in contact with. Fetal bowel may herniate out, get stuck, then never can return. Cause cause amputations and "slash" defects. If this is seen, try to document whether or not baby can move away from it.
    amniotic bands
  16. ______-  scars in uterus from previous instrumentation
  17. With ____________- during pregnancy, amniotic membrane will wrap around the synechiae creating this. Sticky side of amnion can't come in contact with fetus- thicker than amniotic band. Try to move baby away from it. May appear to be a circumvallate placenta.
    amniotic sheets